Most provinces close to targets for surgical wait times: CIHI report

Helen Branswell, The Canadian Press
Published Tuesday, April 14, 2015 12:27PM EDT

TORONTO -- A new report says wait times for key surgeries have held stable for the past five years, even though there have been substantial increases in the number of surgeries being done in some cases.

But the relatively rosy national picture obscures the fact that in some parts of the country, patients wait far longer than recommended for hip and knee replacements and cataract surgeries.

British Columbia and Nova Scotia in particular fared poorly in the assessment, when compared to other provinces.

Meanwhile, efforts to streamline wait times appeared to have paid off in Saskatchewan and Newfoundland and Labrador.

British Columbia's numbers appear to have been dragged down by the fact that the health authority on Vancouver Island decided to tackle a backlog of patients.

CIHI executive Kathleen Morris says working through a list of people who had waited longer than the recommended limit may have temporarily made wait times look worse there than they typically are.

"The question, I guess, is if the strategy is successful and it's a one-time strategy, you'll have one year with funny results and then things will kind of -- hopefully -- go back to a better spot," says Morris, CIHI's director of health system analysis and emerging issues.

"It may just have a one-year, one-time impact on waits."

Meanwhile on the East Coast, Nova Scotia posted the worst numbers for the joint replacement surgeries. The province has high obesity rates and an older population, which increase demand for these procedures.

But so do several other provinces that performed better.

"Nova Scotia, particularly on joint replacements, has historically had a difficult time getting all of the patients done within a timely fashion," Morris says.

The battle to improve wait times for key surgeries began in 2004, with provinces setting targets for hip and knee replacements, hip fracture repairs, cataract surgeries and radiation therapy.

The goal is to ensure that 90 per cent of patients wait no longer than 48 hours for a hip fracture repair, 182 days for the joint replacement procedures, 112 days for cataract surgery and 28 days for radiation.

The 2014 national numbers reveal that 98 per cent of people received radiation therapy within the benchmarked time. For the other procedures, the national averages ranged from 79 per cent (cataract surgeries) to 84 per cent (hip fracture repairs).

For the first time, CIHI was able to compare surgical wait times in Canada with those of several similar countries, including Britain, Finland, Australia and New Zealand.

The Canadian figures were among the best for waits for joint replacement and cataract surgeries, Morris notes.

But that picture might not be as favourable if the time being measured included how long it takes for Canadian patients to see a specialist after their family doctor decides they need one of these five procedures.

The wait-time clock starts ticking from the time a specialist orders the surgery.

Critics have long argued that starting the clock from the visit to the family doctor would give a more realistic picture of the state of care in Canada. Morris says that is the next frontier in the campaign to reduce surgical wait times.

"We know, overall, that Canadians wait much longer than people in other countries on average to see a specialist," she says.

"So it's probably an area where there is opportunity to apply some of the same principles in terms of streamlining the steps and getting people in quickly."